Cardiovascular disease continues to be the world’s dominant killer. This is likely to continue to be the case, particularly as both obesity and diabetes, precursors to heart disease, continue to rise dramatically in the western world. Despite the fact that there are good drugs available to reduce LDL-cholesterol, blood pressure, etc., more advances are clearly needed. Yet, biopharmaceutical R&D investment appears to be waning.

One of the reasons for this can be found in Pfizer halting development of its PCSK9 inhibitor, bococizumab, a potent LDL-c-lowering agent for heart disease. This was not a trivial decision to take. Bococizumab was in the late stages of a clinical program which undoubtedly cost hundreds of millions of dollars.